The role of neighborhood social capital on health and health inequality in rural and urban China

Feb 12, 2022Preventive medicine

How neighborhood trust and support relate to health and health gaps in rural and urban China

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Abstract

Among 5014 Chinese adults, perceived neighborhood social cohesion is positively associated with health in both rural and urban areas.

In rural areas, a neighborhood network of 10 or more people is linked to better health outcomes.
Perceived neighborhood social cohesion shows a similar positive relationship with health in urban areas.
The health gap between income-poor and non-income-poor residents narrows in rural areas as neighborhood network size increases.
Cohesive neighborhoods appear to benefit health for residents in both rural and urban settings.
Health interventions focused on enhancing neighborhood social cohesion may be necessary to address the effects of urbanization.

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Given the "community lost" vs. "community saved" debate on how neighborhood solidarity changes with urbanization, we compared the rural-urban difference in the association of individuals' neighborhood social capital with health and the interaction effect between neighborhood social capital and income-poverty on health in China, where huge rural-urban disparities existed. Participants were 5014 Chinese adults (≥ 18 years) (rural: 2034; urban: 2980) from the 2012 cross-sectional Chinese General Social Survey. Health outcome was a factor score constructed by three items. Neighborhood social capital was divided into structural (neighborhood network size, frequency of socializing with neighbors, voting in neighborhood committee election, and participation in neighborhood voluntary activities) and cognitive (perceived neighborhood social cohesion) dimensions. Multivariable linear regression models showed positive associations between perceived neighborhood social cohesion and health in rural (β = 0.08, 95% CI: 0.03,0.14) and urban (β = 0.09, 95% CI: 0.05,0.12) areas. Only in rural but not urban areas was a neighborhood network of 10 or more persons (ref.: none) associated with better health (β = 0.25, 95% CI: 0.05,0.46). Interaction analysis showed that only in rural but not urban areas, with the increase of neighborhood network size, the health gap between the income-poor and the non-income-poor decreased generally. Our study suggested that cohesive neighborhoods benefit both rural and urban residents' health. Health interventions to improve neighborhood social cohesion should be designed to cope with the challenge of urbanization. Policymakers should avoid damaging neighborhood social capital when implementing other public policies, especially in rural areas where neighborhood network seems to matter more for health.

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The role of neighborhood social capital on health and health inequality in rural and urban China

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